A friend of mine in his 60’s who suffers from chronic pain due to a hereditary condition has always relied on darvocet for pain control, but he tells me that they don’t make it any more. He said it’s because the patent has run out and the drug company can’t make money on it any more. I haven’t researched that part, and anyway, that’s not my question.
He’s been researching effective, non-narcotic replacements for it… something a person can take every day for a long time. The combo of darvocet and ambien is the only thing that enables him to get any sleep. He has a little stockpile of darvocet that will soon run out, and he doesn’t know what he’s going to do after that for pain. I’m not totally familiar with all of the painkillers out there.
I suggested he could get a prescription for darvon and take it with tylenol, and maybe that would work. He’d have to tinker with the dosages a bit. His internist would probably accept any suggestions he could come up with.
His internist should be the one making the suggestions as to what to do.
I’m well-practiced in the prescribing of pain medications, both narcotic and non-narcotic, but I’m not going to offer up any suggestions other than that he needs to work this out with his physician.
Likewise, I can’t make any suggestions, but just want to mention that Darvocet has been pulled from the market, not because of patents, but because the FDA requested its withdrawal. Its active ingredient has been implicated in fatal heart arrhymthias. Painkillers Darvon, Darvocet withdrawn at FDA request
As a sufferer from a very rare genetic disease for 60 years he has discovered that NO ONE cares as much about his well-being as he does. If he didn’t do his own research and then take that knowledge to his doctors, he’d probably be dead by now. His internist, his endocrinologist, his neurosurgeon (none of whom have ever met a person with his disease and likely never will again) all have been pretty useless in finding something to help him with pain relief. Darvocet has been his mainstay.
Anyway, most enlightened doctors expect their patients to be pro-active these days and are not offended or alarmed when patients do their own research. My friend has been visiting patient message boards in this search for information (i.e., what is a good replacement for darvocet), and I told him I’d check here at SDMB.
By all means, don’t make any suggestions. I would not want anyone to violate their ethics or go against their judgment, but I wonder why you chose to post your comment at all?
To give good orderly direction about how the process should work. If his doctor is as useless as you say, he needs a new doctor. There are good pain medicine specialists out there who are very well versed in chronic pain issues. If his case is as complex as you say, that would be a superior approach to fishing the internet for info that might (but most likely won’t) be relevant.
I would appreciate answers to my question rather than a critique of the question itself.
Needless to say, there’s plenty about the sitch I can’t share as it is not my story and frankly wouldn’t share in such a public forum. My friend has been to many many many doctors. He is pro-active and compliant.
If no one wants to answer the question as I have phrased it, that is a-ok. I said I would check here, and I have done that.
The reason I said non-narcotic is that he is aware of narcotic painkiller options. Don’t need that question answered. Already know the answer. This is research, nothing more. Not a substitute for going to the doctor. I hope that is clear.
Ultram (tramadol) is not marketed as a narcotic, and supposedly has less risk of dependence (though I assume that would not be a concern in this case anyway), but works in much the same way as the better-known narcotics.
Wikipedia does describe it an opiate and there are reports that it can indeed lead to dependence.
Darvocet has been off patent for a long time, ever since I got into pharmacy at least. As WhyNot said, it was pulled off the market due to a side effect of arrhythmia’s. As for an idea of replacements, I do question your usage of the words “Non-Narcotic”, Darvocet (propoxyphene/APAP) is an opioid, and an opioid is the definition of “Narcotic”. So, you’re looking for an non-narcotic replacement for a narcotic…
If you really want something that is “Non-Narcotic”, then something like a strong NSAID would possible be best… However, since I’m assuming you are actually talking about stuff like Hydrocodone or Oxycodone, I’m going to 2nd the suggestion to try Tramadol. It affects the opioid receptors, and also has some SSRI type effects. Tramadol was also what we switched most of our patients on propoxyphene to once it was taken off the market.
Though, any better recommendations would require knowing what type of pain he might be having.
Disclaimer: I am not your pharmacist, I’m not your “Friends” pharmacist, I’m probably not even licensed in your state, heck, I’m not even licensed in my own state (yet). This is not medical advice, just something to talk about with your licensed MD.
Perhaps Nucynta (tapentadol) is worth asking about. I don’t know how many doctors know about it - it was only introduced to the US market 2 years ago - and it might not have been included in conversations. I’m on it right now for shoulder surgery yesterday. It seems very helpful but does not have much of a “high” feeling. It’s considered to be as capable as oxycodone.